The NDC Shortage: What the FDA Could (and Should) Do to Address It

Today’s guest post comes from Patricia Milazzo, Senior Director, Embedded Content with Clinical Effectiveness at Wolters Kluwer, Health.

As Patty explains, the U.S. Food & Drug Administration (FDA) will run out of 5-digit National Drug Code (NDC) codes within the next ten to fifteen years. She describes how the FDA can minimize the negative effects of the inevitable change in NDC format.

To learn more about the debates and best practice recommendations, download the complete paper, The NDC Shortage: What the FDA Could (and Should) Do to Address It.

Read on for Patty’s insights.

Drug Channels News Roundup, November 2018: Amazon/PillPack Update, Fake News from BCBSA, Drug List Prices in Ads, Part D Plans, and Dan Best

Hope you enjoyed the Thanksgiving holiday! I remain ever-thankful for your support and readership.

Now that you’ve stretched your stomach, stretch your mind with some food for thought. In this issue:

• Amazon starts to expand PillPack's dispensing capabilities

• Blue Cross Blue Shield misrepresents drug spending data

• An excellent analysis of the CMS proposal for advertising drug list prices

• The patient’s perspective on choosing a Medicare Part D plan

Plus, please consider making a donation to the Dan Best Memorial Fund. Details below.

P.S. For daily updates on stuff that I am reading, join the more than 6,500 people who follow @DrugChannels on Twitter.

P.S.2 Today, I’m at the Forbes Healthcare Summit in New York. I’ll be participating in a panel discussion about drug pricing with Steve Miller from Express Scripts. Please say hello if you’re attending!

Pharmacist Salaries Keep Rising: Hospitals Continue to Lead in Wage and Employment Growth

Time to update our exclusive annual analysis of pharmacist salaries. We again rely on the latest Occupational Employment Statistics (OES) data from the Bureau of Labor Statistics (BLS).

For 2017, the average gross base salary for a pharmacist at a retail, mail, long-term care, and specialty pharmacy reached nearly $122,000—up slightly from the 2016 figure. Meanwhile, the share of pharmacists who work at hospitals reached a new high. Pharmacists who work at hospitals also had higher salaries and greater salary increases than those of pharmacists in outpatient dispensing formats.

Some people have predicted doom and gloom for pharmacists. These latest data show otherwise, though the ongoing shift to specialty drugs is altering long-standing employment patterns. Below, I profile pharmacist employment and salaries. I also offer a few controversial thoughts on U.S. healthcare spending and the industry’s salaries.

CBI’s 12th Hub and SPP Model Optimization

CBI’s 12th Hub and SPP Model Optimization
February 26-27, 2019 | Philadelphia, PA
www.cbinet.com/hubs

As the industry’s acclaimed event for hub and SPP model optimization, CBI’s 12th Hub and SPP Model Optimization conference brings together perspectives from manufacturers, payers, specialty pharmacies, hubs, PBMs, technology providers and more. You can't miss this timely meeting as you prepare to launch, transition or reboot your corporate or product approach to hub services!

Visit www.cbinet.com/hubs for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code TJR752 and register prior to December 21st.*

CBI’s 12th Hub and SPP Model Optimization provides next-generation insights and strategies for service model design and enhancement to improve access and outcomes. By way of case studies, master classes and panels on stakeholder collaboration, compliance risks, technology advancements, auditing third-parties, nurse educator programs, contracting, data reporting, hub enrollment and more, you’ll return to the office ready to advance your organization to stay ahead in 2019.

You can sign up to see the agenda here.

Here’s an inside look at what you can expect:

• Navigate the Complexities of Reimbursement and Access to Propel Adherence and Outcomes
• Down Wall Street — Examine Revolutionary Deals, Breakthroughs and E-Commerce Players Impacting the Life Science Marketplace
• Uncover Emerging Enforcement Trends and Top Risk Areas for 2019 and Beyond
• Collaborate with Compliance—From Program Development to Monitoring and Auditing Third-Party Providers
• Assess Powerful Partnership for Clinics and Patients—Aligning Manufactures, Hubs and SPPs to Minimize Duplication and Streamline Access
• Discuss How Patient Support Is Driving Meaningful Outcomes for Value-Based Reimbursement
• Evaluate Industry’s Leading Hub and SPP Models
• Hear What’s on the Horizon for Hubs—A Look into the Continued Evolution and Advancement of Services Accelerating Access
• Enhance Electronic Benefit Verification and Prior Authorizations to Decrease Time to Fill and Optimize HCP Workflow

PLUS! New this year – benefit from the Master Class Series:

• Copay Accumulator Download—Forecast and Manage the Impact on Patients and Manufacturers
• Elevate Efficiency and Value of the Hub while Reducing Costs
• Nurse Educator Programs—Compliant Program Design and
• Align Distribution Channel Strategies with Hub and SPP Model Design
• Optimize Compliant Quick Start and Bridge Programs
• Revamp and Restructure Contracting Agreements for Specialty Data to Create Operational Efficiencies

Visit www.cbinet.com/hubs for further details and to register. Drug Channels readers will save $400 off the standard rate when they use code TJR752 and register prior to December 21st.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. Other restrictions may apply.

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The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

CBI’s 14th Life Sciences Trade and Channel Strategies

CBI’s 14th Life Sciences Trade and Channel Strategies
December 11-12, 2018 | Philadelphia, PA
www.cbinet.com/trade

Don’t miss the life science industry’s favorite event where the experts will share how to expand the playbook on product-specific network design, contracting and specialty distribution strategy.

Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $200 off the standard rate when they use promo code FPH346 and register prior to November 30th.*

Gain critical insights on industry trends, political impact, market dynamics and product-specific channel strategies. Key stakeholders come together to navigate the complex distribution and contracting landscape and discuss ways to optimize channel strategies in order to reach patients in need and provide the necessary services based on product type, site of care and reimbursement.

You can read all about it here.

• Hear from Adam J. Fein, Ph.D., Chief Executive Officer, Drug Channels Institute as he provides a Drug Channels Update—Things to Watch in 2019
• Gain insight from William Roth, Founding Partner Blue Fin Group as he addresses the Fragmentation and Customization Coming to Pharmaceutical Channels
• Walk down Wall Street as industry analysts sound off on the Cigna-Express Scripts deal and the CVS-Aetna deal as well as Amazon’s entrance into the marketplace
• Navigate the evolving managed care landscape and identify emerging models in utilization management to enhance product access and network design
• Discover leading distribution models based on product type (specialty pharmacy benefit, specialty medical benefit, orphan/rare, gene therapies, complex generics)
• Measure the impact of Copay Accumulator Programs on patients and manufacturers
• Customize your experience through a master class series:
• Integrating pharmacy and medical benefits
• Specialty pharmacy strategy design for biosimiliars and on-market brands
• Navigate limited and closed pharmacy network models
• Patient support programs and hub services
• Advanced SP contracting
• Managed markets compliance

Visit www.cbinet.com/trade for further details and to register. Drug Channels readers will save $200 off the standard rate when they use promo code FPH346 and register prior to November 30th.*

See you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. Other restrictions may apply.

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The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Commercializing Cell and Gene Therapies with High-Touch Services

Today’s guest post comes from Layne Martin, VP/GM, Specialty Distribution and Third-Party Logistics at McKesson Life Sciences.

Companies commercializing cell and gene therapies face many novel challenges, including: supply chain logistics, patient access, adherence, outcomes collection, and data analysis. Layne reviews the crucial issues and explains the services needed for success.

McKesson Life Sciences has developed a portfolio of patient-centric solutions to help cell and gene therapy companies. To learn more, download their new white paper: The Key to Commercializing Revolutionary Gene Therapies and Other Orphan Drugs.

Read on for Layne’s insights.

Express Scripts Launches a New Formulary for a World Without Rebates. Will Plan Sponsors and Drug Makers Play Along?

Express Scripts has just announced its National Preferred Flex Formulary, a new option that favors drugs with lower list prices over the high-list/high-rebate versions of these products. Click here to read the press release.

This new formulary signals that Express Scripts is trying to prepare its plan sponsor clients for a world without rebates. The formulary also provides a way for Express Scripts to prepare itself for such a world.

As I explain below, many plan sponsors embrace the warped incentives of the gross-to-net bubble—the ever-growing pile of money between a manufacturer’s list price for a drug and the net price after rebates and other reductions. I outline two crucial payer and PBM factors that make it difficult for manufacturers to cut list prices and pop the gross-to-net bubble.

Express Scripts’ new formulary challenges plan sponsors that are addicted to rebate dollars. Let’s see how many plan sponsors will prefer a low list-price over a high-list/high-rebate product—and how many more manufacturers will respond with lower list prices.

13th Annual Health Care Supply Chain Summit

13th Annual Health Care Supply Chain Summit
January 28-29, 2019 | New Orleans, LA

Join senior supply chain executives from top hospitals as they share strategies to improve patient outcomes by optimizing and benchmarking supply chain operations.

Key Themes in World Congress’ 13th Annual Health Care Supply Chain Summit 2019 include:

• Cost, quality and outcomes
• Clinical integration and physician alignment
  
• Supplier relationships
  
• Sustainability and standardization
  
• Strategic planning
  
• Value analysis and strategic sourcing
  
• Data, analytics, and technology
  
• Talent acquisition, supply chain leaderships, and professional development
  
• Logistics and distribution
  

Engage in strategic discussions regarding next frontier supply chain operations with leaders from: Ochsner Health System | Mayo Clinic | AHRMM | Stanford Health Care | UPS | Mount Sinai Health System | Boston Children’s Hospital | and more!

Download the 2019 brochure.

Ready to register? Use promo code DC200 and save $200 off of current rates.

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The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Enhancing Care For and Management of Hepatitis C Patients

Today’s guest post comes from Lily Duong, Chief Clinical Officer at Therigy.

Lily discusses challenges treating Hepatitis C patients and explains how a specialty patient management platform can improve outcomes.

She introduces Therigy’s latest publication series: Specialty Pharmacy Standards of Care. Download the first volume in this series here: Specialty Pharmacy Standards of Care: Hepatitis C.

Read on for Lily’s insights.

Drug Prices After the Midterms: Five Crucial Implications of Pharmacy Benefit Design

After Tuesday's election, House minority leader Nancy Pelosi pointed to "reducing the cost of prescription drugs" as a legislative priority. But addressing patient affordability issues will require more than decrying “high drug prices.”

Today, I highlight five implications of these benefit designs on patient affordability, out-of-pocket costs, and perceptions of prescriptions prices. My observations are based on Employer Pharmacy Benefits in 2018: More Tiers, Greater Coinsurance, and Lots of High-Deductible Plans, in which I summarized companies’ 2018 prescription drug coverage for their employees.

As I explain below, many aspects of employers’ plans are unfriendly to patients with serious medical conditions and to those who face coinsurance and high-deductible plans. What’s more, most employees don’t understand their increasingly complex prescription insurance.

If politicians want to get serious about controlling how voters feel about their prescription costs, they should focus on understanding the structure of commercial and Medicare Part D benefit designs.

Employer Pharmacy Benefits in 2018: More Tiers, Greater Coinsurance, and Lots of High-Deductible Plans

It’s time for a deep dive into the 2018 Kaiser Family Foundation Employer Health Benefits Survey, which you can read online for free. The survey provides valuable national benchmarking for employer-sponsored health coverage in 2018.

If you’d rather not to wade through the entire report, please enjoy my highlights on prescription coverage below. I summarize employers’ 2018 pharmacy benefits by examining (1) cost sharing tier structures, (2) prevalence of copayment vs. coinsurance, and (3) average copayments and coinsurance rates, by formulary tier. I breakdown the 2018 results for plans with and without high deductibles.

For 2018, employers continue to increase cost-shifting for specialty drugs. Most plans have four or more tiers. Economically debilitating coinsurance—in some cases with no limit on out-of-pocket expenses—remains distressingly common. Many people with employer-sponsored insurance are being exposed to prescription list prices, regardless of the actual net, post-rebate costs.

In a follow-up article, I’ll provide thoughts on what employers’ benefit designs mean for patient affordability, out-of-pocket costs, and perceptions of prescriptions prices. Spoiler: Patients won’t be looking like they are having fun.

CBI’s Specialty Therapies 2019

CBI’s Specialty Therapies 2019
January 24-25, 2019 | Las Vegas, NV
www.cbinet.com/specialtytherapies

Kick off 2019 in Las Vegas at Specialty Therapies 2019! Don’t miss the chance to come together with colleagues from across the industry to examine disruptions in specialty drug distribution and the impact on access, quality and cost. You can read all about it here.

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

With the advent of innovative service delivery models, alternative payment models and an emphasis on data sharing and data standardization, the quest to drive better outcomes, ensure access and manage costs is more vital than ever.

Experts from Ochsner Health System, Ardon Health, Moda Health, Vanderbilt University Medical Center, Atrium Health, Indiana University Health, Fairview Specialty Pharmacy, MedImpact Health Systems, Boesen & Snow Law, Diplomat, VIVIO Health, University of Arizona Cancer Center and Blue Cross Blue Shield North Carolina lead robust discussions on topics such as:

• Investigate how distribution channels for specialty therapies are changing and the impact on cost, access and health outcomes
• Understand how in-house specialty pharmacies can enable health systems to accelerate a patient’s speed-to-therapy and improve quality of care through integrated clinical coordination
• Evaluate the potential impact of the removal of safe harbor for drug rebates
• Consider how distribution channels that accommodate 340B hospital pharmacies, PBM owned pharmacies, limited distribution drugs, any willing provider legislation and closed specialty networks affect clinical outcomes and costs
• Unravel the complexities within Copay Accumulator Programs and how they will affect specialty therapy utilization rates and long-term medical spend

Visit www.cbinet.com/specialtytherapies for further details and to register. Drug Channels readers will save $400 off the standard rate when they use promo code BQH229 and register prior to November 30th.*

CBI will see you there!

*Cannot be combined with other offers or used towards a current registration. Cannot be combined with special category rate or non-profit rates. Other restrictions may apply.

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The content of Sponsored Posts does not necessarily reflect the views of Pembroke Consulting, Inc., Drug Channels, or any of its employees.

Surprise Deal: Cardinal Health Sells Its Specialty Pharmacy (Again)

The evolving specialty market has just claimed another victim. Cardinal Health is selling its specialty pharmacy to BioMatrix Specialty Pharmacy LLC, a private-equity-backed company. There was no public announcement, so today's article counts as another Drug Channels exclusive. Below, I provide background about BioMatrix and the specialty pharmacies that wholesalers operate.

Cardinal’s capitulation highlights the challenges for smaller specialty pharmacies. Cardinal operates a small, sub-scale specialty pharmacy that has had difficulty attracting patients. What’s more, Cardinal’s overall size as a $137 billion business couldn’t help its pharmacy gain sufficient access to manufacturers’ and payers’ limited networks.

Each of the Big Three wholesalers—AmerisourceBergen, Cardinal Health, and McKesson—is encountering challenges to its diversification efforts. Will Cardinal’s move prompt a rethinking of wholesalers’ broad business portfolios over the next 12 to 18 months?